Comparison of 6-hour infusion versus bolus furosemide in premature infants.
OBJECTIVE
To compare the renal, hemodynamic, and pulmonary effects of a 6-hour infusion of furosemide versus conventional bolus administration in premature infants.


METHODS
Prospective, blinded, placebo-controlled, randomized study.


METHODS
Two level III, university-based neonatal intensive care units.


METHODS
Thirty premature infants with significant lung disease, requiring furosemide after a red cell infusion.


METHODS
Infants received furosemide 1 mg/kg over 2 minutes, followed by a 6-hour placebo infusion, or a small loading dose of 0.1 mg/kg, followed by a slow infusion of 0.9 mg/kg over 6 hours. Serum and urine were collected to determine percentage fractional excretion of sodium (FENa).


RESULTS
Urine output and blood pressure were measured every 2 hours after furosemide administration. Percentage FENa was measured immediately before furosemide and compared with pooled urine from an 8-hour collection after furosemide administration. Serum sodium, creatinine, and calcium were measured before and 24 hours after drug administration. Mean airway pressure and percentage inspired oxygen were compared before, 1-4 hours after, and 4-12 hours after drug administration. No significant differences were detected between the two methods of drug administration.


CONCLUSIONS
Our data suggest that a 6-hour infusion of furosemide does not offer substantial clinical advantage over conventional bolus administration in premature infants when focusing on urine output, blood pressure, FENa, or pulmonary effect.
Reiter
P D
PD
Department of Pharmacy, University Hospital, School of Pharmacy, Denver, CO 80262, USA.
Makhlouf
R
R
Stiles
A D
AD
D001794:Blood Pressure / Q000187:drug effects; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy*; D004232:Diuretics / Q000008:administration & dosage*; D005665:Furosemide / Q000008:administration & dosage*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D011446:Prospective Studies; D012119:Respiration / Q000187:drug effects; D014882:Water-Electrolyte Balance / Q000187:drug effects
D004232:Diuretics; D005665:Furosemide